One of the first questions aspiring parents ask when considering fertility treatment is “How much does IVF cost?” As you might expect, costs vary depending on many factors. This helpful overview provides answers to that major question and other questions surrounding a patient’s fertility journey.
Every patient has a unique story and RMA’s experienced and compassionate fertility specialists are here to listen to yours and recommend the right treatment plan for starting your family.
Most couples get married with dreams of starting a family. Once the wedding day is behind them and day-to-day life sets in, the urge to feather and fill their nest usually follows. But in some cases, that nest stays empty longer than expected as attempts to conceive naturally prove difficult.
Which then prompts some key questions. Why is this happening? How long should we keep trying before seeing a fertility specialist? And, if we do end up needing fertility care, how much will it cost?
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According to the National Institutes of Health, “infertility is defined clinically as not being able to achieve pregnancy after one year of having regular, unprotected intercourse [if the woman is younger than 35] or after six months if the woman is older than 35 years of age.”
So if a couple has been trying to conceive for more than a year, it is likely they have fertility issues.
Fortunately, many issues can be resolved with fertility treatment, which is why it is best to consult with a fertility specialist, especially if the female partner is over 35 years old, since the quantity and quality of a woman’s eggs decline with age, and that decline speeds up after a woman turns 35.
During an initial exam at RMA, our specialists review the health histories of both partners and perform tests to determine what might be getting in the way of a natural pregnancy.
In some cases, simple procedures or medications can help. However, certain diagnoses may point to the need for In Vitro Fertilization (IVF) treatment, which has high success rates.
IVF is often seen as the most effective, direct route to pregnancy – and the birth of a healthy baby – for patients who want to start a family sooner than later, since preliminary treatments, like the medication Clomid, or the procedure Intrauterine Insemination (IUI), while less expensive, can take longer, have lower success rates and may not be an option at all for patients with certain conditions.
And, of course, IVF is a great solution for many in the LGBTQ community, as well as single-by-choice individuals looking to start their families.
But, at what cost?
An online search for the average cost of IVF brings up numbers that are often inaccurate or conflicting, mostly because they do not include the full spectrum of costs associated with treatment. This is why it is best to speak directly to a financial coordinator at your clinic to get the exact breakdown.
One thing that shows up right away in a comparative search is that not all clinics are alike, and there is no standard cost for IVF.
For example, while the Society for Assisted Reproductive Technology (SART) estimates the average cost of an IVF cycle in the U.S. to be $10,000 – 15,000, they warn that costs are dependent on the treatment center, patient characteristics, and insurance coverage.
In other words, costs vary. Patients with good insurance and a favorable outcome after the first cycle (eliminating the need to go through additional IVF cycles, which would cost more) will pay less than those without insurance and the need to do several cycles.
The quality of a clinic will also impact the cost.
Keeping the above factors in mind, prospective patients should inquire about every aspect of care before making a decision.
Many clinics offer services “a la carte” style, with each step essentially having its own cost. The most common steps are outlined below:
- Initial fertility consultation with a doctor
- Initial blood work and ultrasound
- Follow up blood work
- Diagnostic testing/procedures
- IVF medications
- Egg retrieval (freeze all)
- Intracytoplasmic Sperm Injection (ICSI)
- Embryo biopsy
- NexCCS genetic testing
- Embryo freezing
- Embryo transfer
One aspect of care patients are not sure they should invest in is genetic embryo testing, also known as preimplantation genetic testing or Comprehensive Chromosome Screening (CCS). RMA’s proprietary screening tool is called Next Generation CCS, or NexCCS.
This procedure involves taking a biopsy of an embryo and testing it for chromosomal abnormalities (too many or too few chromosomes).
Because the test identifies which embryos are normal, doctors can implant the single best embryo into a woman’s uterus, dramatically increasing her chances of pregnancy, ongoing pregnancy and the birth of one healthy baby.
An RMA study that looked into the cost-benefit of NexCCS found that for women with more than one embryo, the test saves money, reduces time to live birth and reduces the risk of failed transfers and miscarriage. It also greatly reduces risks to mother and child associated with multiple gestations.
RMA’s standard of care, Frozen Embryo Transfer (FET) and Single Embryo Transfer (SET), using NexCCS, leads to higher success rates. SET reduces the risk of multiples (twins or triplets) and FET allows doctors to schedule the transfer at a time when the uterus is in its most optimal state to receive the embryo.
Years of research conducted by RMA has shown increasingly high success rates using this unique protocol, so it is now standard at RMA.
The good news is, an initial cost quote is not an indicator of how much a patient will pay out-of-pocket for IVF treatment since IVF insurance coverage plans vary. The benefits administrator at a patient’s place of employment can confirm whether fertility is covered, and, if so, what portion of care will be covered.
RMA accepts many insurance plans, however, even if fertility coverage is offered, benefits vary. RMA recommends patients call their insurance carrier to clarify the following before starting IVF treatment:
- Exact details of coverage
- Which diagnostic tests are included or excluded
- Whether ultrasound imaging is covered
- Whether IUI is covered, and how many attempts
- Whether IVF is covered, and how many cycles
- Whether it is necessary to complete one course of treatment before pursuing another, such as IUI before IVF
- Whether there is any coverage for medications
- Whether any medical criteria must be met before approval for the treatment
The national infertility association, Resolve.org, keeps track of efforts to pass legislation mandating fertility coverage in each state and publishes a detailed report on the progress of those efforts. Patients living in states without fertility coverage may want to contact legislators in their home state to ask about pending legislation and to voice their support.
Prospective patients can also benefit from an initial consultation with a fertility specialist before choosing a new health plan during their employer’s annual open enrollment period.
Basic tests like blood work and ultrasound can help determine what kind of care a patient will need. This information will be useful when reviewing plan options. Here are some helpful tips to keep in mind when searching for a fertility-friendly health plan.
- Employers tend to offer a limited number of plans, each with different benefits. Search the policy for an “infertility” or “IVF” or “family planning” section and closely review inclusions and exclusions. For example, IVF may be covered but not tests or procedures.
- If a designated fertility section is not listed anywhere in the policy, inquire about coverage as it relates to medical codes. For example, the code for Intrauterine Insemination (IUI) is 58322, an egg retrieval necessary for IVF and egg freezing is 58970, and Intracytoplasmic Sperm Injection (ICSI) is 89280. A benefits administrator can answer any questions about codes.
- Find out which plans are more fertility-friendly. For example, many New Horizon Blue Cross Blue Shield Omnia plans in New Jersey cover IUI.
- Even if a state has strong laws for employers to offer fertility benefits, some employers may not be required to follow the mandate, so it is best to inquire.
- Don’t assume a good insurance brand means great fertility benefits. For example, some Aetna plans include infertility benefits while others offer none. Compare each plan within a brand.
- If you decide to switch insurance plans, talk to your family first. Changes to out-of-pocket expenses should be a decision you make with the entire family in mind.
- If an employer offers no fertility benefits, inquire about “shared risk programs” that are offered by some clinics. Even if your initial out-of-pocket expense is higher, these programs, like RMA’s CareShare program, can reduce the cost per cycle of treatment, for patients who qualify.
The other good news is, if fertility treatment is not covered under a patient’s health plan, RMA financial counselors can guide patients toward several financing programs. Lower cost options are also available to those who qualify.
RMA participates with ARC Fertility, a program that offer lower-cost options to qualified patients. In addition, RMA is affiliated with a number of specialty lending institutions that can help patients finance their treatment. Each of these offers different terms, so patients should compare to find a plan that best fits their needs.
Below is a list of RMA-affiliated lenders. Participation varies at each clinic, so patients should call RMA’s financial counselors to clarify which lenders work with their clinic location. Here are some examples of lenders that participate with RMA clinics in various locations.
- Lending Club – New Life Fertility Finance
- Prosper Healthcare Lending
- Future Family
- United Medical Credit
It is critical for prospective IVF patients to consider other factors besides cost before taking such a big step. Other questions to ask include:
- How experienced are the doctors?
- Are they also researchers in the field?
- Is the clinic a teaching institute or affiliated with one?
- How advanced is the technology in their labs?
- What are their success rates?
- Are the embryologists well-trained?
- How advanced is the embryology lab?
- Do the doctors make themselves available to patients outside of the first appointment?
- Is the care team supportive and compassionate?
- Do they provide flexible monitoring hours?
- Is the staff passionate about what they do?
- Is the clinic globally recognized?
- Is the administrative staff accommodating and efficient, and do they treat you with patience and respect?
The RMA Difference
Highly-qualified, experienced doctors play a huge role in RMA’s success, as do the conditions and offerings at our clinics and labs.
While patient success stories are the end goal of our work, RMA’s ongoing commitment to advanced research continues to set new benchmarks for the industry. And as a globally-recognized teaching institute turning out the best Reproductive Endocrinologists (REI) in the field, we are proud of our now 20-year family-building and industry-leading legacy.
Our recent merger with IVI, Europe’s largest fertility provider, has us celebrating the delivery of over 200,000 babies since 1990, and further increases our ability to provide our patients with the highest level of care.
In support of that ongoing commitment, we continue to invest in research, resources, staff and advanced technologies that lead the way in the field of fertility medicine, with the goal of making the path to parenthood ever safer and more successful.